Penetration of Chlorhexidine into Human Skin

Life and Health Sciences, Aston University, Aston Triangle B4 7ET, United Kingdom.
Antimicrobial Agents and Chemotherapy (Impact Factor: 4.48). 09/2008; 52(10):3633-6. DOI: 10.1128/AAC.00637-08
Source: PubMed


This study evaluated a model of skin permeation to determine the depth of delivery of chlorhexidine into full-thickness excised human skin following topical application of 2% (wt/vol) aqueous chlorhexidine digluconate. Skin permeation studies were performed on full-thickness human skin using Franz diffusion cells with exposure to chlorhexidine for 2 min, 30 min, and 24 h. The concentration of chlorhexidine extracted from skin sections was determined to a depth of 1,500 microm following serial sectioning of the skin using a microtome and analysis by high-performance liquid chromatography. Poor penetration of chlorhexidine into skin following 2-min and 30-min exposures to chlorhexidine was observed (0.157 +/- 0.047 and 0.077 +/- 0.015 microg/mg tissue within the top 100 microm), and levels of chlorhexidine were minimal at deeper skin depths (less than 0.002 microg/mg tissue below 300 microm). After 24 h of exposure, there was more chlorhexidine within the upper 100-microm sections (7.88 +/- 1.37 microg/mg tissue); however, the levels remained low (less than 1 microg/mg tissue) at depths below 300 microm. There was no detectable penetration through the full-thickness skin. The model presented in this study can be used to assess the permeation of antiseptic agents through various layers of skin in vitro. Aqueous chlorhexidine demonstrated poor permeation into the deeper layers of the skin, which may restrict the efficacy of skin antisepsis with this agent. This study lays the foundation for further research in adopting alternative strategies for enhanced skin antisepsis in clinical practice.

Download full-text


Available from: Tony Worthington
    • "Although chlorhexidine is well tolerated, it is reported to have delayed hypersensitivity reaction when used on the skin and also anaphylaxis is reported when in contact with mucous membrane.[12] However, we did not report any skin irritation or allergy among all 400 blood donors included in the study and among technical officers and nurses. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A prospective study was undertaken to evaluate the use of 2% (w/v) alcoholic chlorhexidine gluconate (2% AlcCHG) in donor arm preparation, to monitor the contamination rate of blood products after the collection and to find incidence of transfusion associated bacteremia.
    No preview · Article · Mar 2014 · Asian Journal of Transfusion Science
  • Source
    • "Even after careful disinfection, regrowth of the skin flora occurs consistently under the transparent dressing, due to the migration of bacteria from the dermis to the epidermis and to the limited efficacy of antiseptic solutions under the superficial skin [66]. Chlorhexidine-impregnated dressings prevent micro-organism regrowth in the epidermis. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Catheters are the leading source of bloodstream infections for patients in the intensive care unit (ICU). Comprehensive unit-based programs have proven to be effective in decreasing catheter-related bloodstream infections (CR-BSIs). ICU rates of CR-BSI higher than 2 per 1,000 catheter-days are no longer acceptable. The locally adapted list of preventive measures should include skin antisepsis with an alcoholic preparation, maximal barrier precautions, a strict catheter maintenance policy, and removal of unnecessary catheters. The development of new technologies capable of further decreasing the now low CR-BSI rate is a major challenge. Recently, new materials that decrease the risk of skin-to-vein bacterial migration, such as new antiseptic dressings, were extensively tested. Antimicrobial-coated catheters can prevent CR-BSI but have a theoretical risk of selecting resistant bacteria. An antimicrobial or antiseptic lock may prevent bacterial migration from the hub to the bloodstream. This review discusses the available knowledge about these new technologies.
    Full-text · Article · Aug 2011 · Annals of Intensive Care
  • Source
    • "However, the efficacy of CHG is reduced in the presence of organic matter and at low pH [1]. Furthermore, CHG, as with other antiseptic preparations exhibits restricted penetration through the skin; our previous studies demonstrate that CHG from aqueous and alcoholic [70% (v/v) isopropyl alcohol (IPA)] solutions poorly penetrate the full thickness skin to the deeper skin layers [2,3]. This limits its efficacy against microorganisms residing in the lower layers of the epidermis and dermis, including hair follicles and sebaceous glands [2-6]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Chlorhexidine digluconate (CHG) is a widely used skin antiseptic, however it poorly penetrates the skin, limiting its efficacy against microorganisms residing beneath the surface layers of skin. The aim of the current study was to improve the delivery of chlorhexidine digluconate (CHG) when used as a skin antiseptic. Chlorhexidine was applied to the surface of donor skin and its penetration and retention under different conditions was evaluated. Skin penetration studies were performed on full-thickness donor human skin using a Franz diffusion cell system. Skin was exposed to 2% (w/v) CHG in various concentrations of eucalyptus oil (EO) and 70% (v/v) isopropyl alcohol (IPA). The concentration of CHG (μg/mg of skin) was determined to a skin depth of 1500 μm by high performance liquid chromatography (HPLC). The 2% (w/v) CHG penetration into the lower layers of skin was significantly enhanced in the presence of EO. Ten percent (v/v) EO in combination with 2% (w/v) CHG in 70% (v/v) IPA significantly increased the amount of CHG which penetrated into the skin within 2 min. The delivery of CHG into the epidermis and dermis can be enhanced by combination with EO, which in turn may improve biocide contact with additional microorganisms present in the skin, thereby enhancing antisepsis.
    Full-text · Article · Sep 2010 · BMC Infectious Diseases
Show more